Bring a stockpot of water to a boil over high heat. Add a teaspoon of salt to the boiling water, then add fettuccine. Cook until al dente (check package instructions). Reserve about 1 cup of the pasta water.

Meanwhile, melt butter over medium-low heat. Stir in garlic and cook for about a minute, careful not to burn. Stir in half & half, Parmesan, pumpkin and nutmeg. Stir until sauce is heated through and cheese is melted. Stir in pasta water, about 1/4 cup at a time, until sauce is desired consistency (I used about 1/2 a cup, and it was thick and creamy. For a thinner sauce, use more pasta water).

Add pasta and cook over medium-high heat until sauce is smooth and pasta is well coated; about 1-2 minutes.

Divide into bowls and garnish with parsley and more grated Parmesan, if desired.